Foals Flashcards

(134 cards)

1
Q

What do you need to be careful of when dosing foals

A

Dosages need to change as the foal grows ~1kg a day

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2
Q

Differences between neonates and adults dosing

A

Dynamic dosages
Increased oral bioavailability
Volume distribution (increased %water)
Decreased plasma proteins
Decreased metabolic and excretory activity

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3
Q

What should you assume in sick foals

A

Septic till proven otherwise

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4
Q

Treatment for foal sepsis

A

Antimicrobials
Hemodynamic support
Supportive care

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5
Q

Examples of low sepsis risk

A

Unobserved foaling/meconium impaction

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6
Q

Example of moderate sepsis risk

A

Umbilical infection

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7
Q

Example of high sepsis risk

A

Dystocia
Neonatal encephalopathy

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8
Q

Examples of septic foals

A

Neonatal encephalopathy+ septic joint
Enterocolitis

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9
Q

Treatment for low/medium sepsis risks

A

Oral TMPS (trimethoprim sulphadiazine) 30mg/kg BID

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10
Q

Treatment for high risk sepsis/septic foals (normal renal function)

A

IV sodium penicillin 22mg/kg every 6h
IV gentamicin 12mg/kg every 36h

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11
Q

Treatment for high risk sepsis/septic foals (abnormal renal function)

A

IV centiofur 5mg/kg every 12 h

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12
Q

What should you be careful of with oxytetracycline in foals

A

Kidney damage
Causes tendon laxity

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13
Q

What should be avoided in sedating a foal

A

Alpha 2 agonists - bradycardic

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14
Q

Should you use nsaids in foals?

A

Only if very necessary. Side effects much worse than in adults

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15
Q

What other therapeutics should be used in a hospitalized foal

A

Sucralfate +/- PPIs

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16
Q

What should be used for a dehydrated/hypovolemic foal

A

20ml/kg Hartmann’s (repeat up to 3x)

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17
Q

Treatment for mild obtundation/not nursing

A

250-500ml good quality colostrum via NGT

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18
Q

Treatment for FPT

A

Plasma 20ml/kg -/+ further 20-40 ml/kg based on IgG post transfusion
Transfuse SLOWLY watch for reactions

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19
Q

Best sedation for foals

A

Diazepam+/- butorphanol

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20
Q

Normal heart rate for a foal at birth

A

60-80

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21
Q

Normal heart rate for a foal at 1h

A

120-150

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22
Q

Normal heart rate for a foal 1-5 days old

A

80-100

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23
Q

Respiratory rate for foal at birth

A

60-80

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24
Q

Respiratory rate for a foal from 1hour old

A

~30

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25
When should crackles not being present on lung auscultation
24 hours onwards
26
When is a patent ductus arteriosus normal in a foal
Under 96 hours
27
Normal temperature for a foal
Under 38.9°C
28
Normal timings for a foal
Sternal 5mins Standing 1h Suck reflex 30m-2h Nursing 2h Urinating 4h Defecating 4h
29
What should you advise the owner to do with a newborn foal
Save placenta Treat umbilicus within 4 hours (0.5% chlorhexidine or 2%iodine Check nursing,urination and defecation
30
What should be checked at a newborn foal check
umbilicus (hernia/treatment) Nursing (latching/milk return) Palate (over/undershot jaw, cleft palate) Anus (is there one/meconium) Eyes (entropion/haemorrhage) Chest (heart/lungs/ribs) Limbs (flexural/angular deformities) IgG if 24hours upwards
31
What actions/treatments can you support a newborn foal with
IgG test Enema (more needed in colts) Tetanus antitoxin
32
What care should be taken examining a foal
Wear clean gloves Always restrain in vision of mard Always put one arm around chest and one under belly
33
Where should you avoid giving IM injections in the foal
Neck - pain prevents nursing
34
What size needle should you use for IV in the foal
20G 1inch
35
What looks like a alien on ultrasound
Urachal remnant (Eyes are left and right umbilical arteries)
36
How often should a foal feed
5-6 times an hour
37
How big is a foals stomach capacity
1l in 50kg
38
How much of bodyweight should be consumed per 24 hour period
20% (10l in 20kg)
39
Why should you use milk replacer at 3/4 strength
Decreased risk of constipation
40
Maternal risk factors for an obtunded foal
Dystocia Concurrent illness Gestation (short) Bonding Parity
41
Placental risk factors for an obtunded foal
Placentitis Placental insufficiency
42
Foal factors for the obtunded foal
FPT Sepsis Encephalopathy Omphalitis Congenital defects Trauma
43
Cut off values for IgG tests
>800mg/dL normal 400-800mg/dL partial failure <400mg/dL complete failure
44
Clinical signs of hypoglycemia in the foal
Obtunded +/- seizures
45
What should the first urination be
Hypersthenuric >1.030 Within 8-10 hours in coly and 10-12 in filly it should be hyposthenuria <1.008
46
What is common to see on haematology
Leukopenia and neutropenia with increased band neutrophils
47
What does increased fibrinogen at birth show
In uterine infection/inflammation
48
At what temperature is a foal classified as having a fever
>39.2
49
At what temperature is a foal classified as hypothermic
<37.2
50
Broad causes of obtundedness
Sepsis/SIRS Neonatal encephalopathy Prematurity/dysmaturity
51
Common name for neonatal encephalopathy
Neonatal maladjustment syndrome
52
What defines premature vs dysmature
Premature <320 days Dysmature full term but acts premature
53
Characteristics of a premature foal
Small in size Rounded forehead Silly hair coat Entropian Floppy ears Flexor/periarticular laxity Carpal/fetlock contracture Incomplete ossification of cuboidal bones
54
Prognosis of premature
Good with right care if born >300 days can catch up to peers
55
What is neonatal isoerythrolysis
Destruction of red blood cells due to pre-formed anti red blood cells antigens ingested in colostrum
56
How does neonatal isoerythrolysis occur
Mare becomes sensitized to an antigen (often via stallion from previous foals or blood transfusion) Antibodies absorbed in the colostrum then attack the foals own blood cells
57
Clinical signs of neonatal isoerythrolysis
Pale MM Weakness Obtundation Tachycardia Tachypnea and or dyspnea Seizures Pigmenturia
58
Diagnosis of neonatal isoerythrolysis
History/clinical exam -marked anaemia 10-20% Declining PCV (good evidence) Definite - agglutination/lytic tests
59
Treatment of neonatal isoerythrolysis
If under 24h withhold from nursing Can deteriorate rapidly - refer/whole blood transfusion - must be from universal donor AaQq negative horse Supportive care
60
What is classes as tachycardia (under and over 3 days)
Under 3 days - 115bpm Over 3 days - 120
61
What classes as tachypnoea
>56bpm
62
Normal venous blood lactate foal
<5 under 3 days <2.5 over 3-14 days
63
Causes of meconium impaction
Enterocolitis Dysmotility SI strangulation Congenital abnormalities Intussusecption Hernias Gastric ulceration Lactose intolerance
64
Signs of meconium impaction
No meconium Colic Tail flagging
65
Signs of enterocolitis
D+ Colic Tail flagging Sepsis
66
Signs of dysmotility
Colic Tail flagging Sepsis
67
Signs of SI strangulation
Colic Sepsis
68
Signs of congenital abnormalities (gi/foal)
Colic Lock of faeces
69
Signs of intussusecption
Colic Refux Sepsis
70
Signs of hernias
Colic Nothing if not strangulating
71
Signs of gastric/duodenal ulceration
Colic Reflux Tail flagging
72
Signs of lactose intolerance
D+
73
Signs of uroabdomen
Tail flagging, posturing Stranguria Dysuria
74
Signs of urinary congenital abnormalities
Dysuria Stranguria Urinary incontinence
75
Signs of Umbilical infection
Colic tail flagging Sepsis
76
First line of treatment for meconium impaction
Phosphate enema (Max 2 in 24h)
77
What do you see in ultrasound of meconium impaction
Hypo/anechoic speckled appearance with intestine contracted around meconium
78
How is acetyl cysteine enema administered
Foal sedated in lateral with lifted hindend Foley catheter inserted into rectum and gently cuffed 150-200ml 4% acetyl cysteine gravity flowed into rectum. Clamp closed and catheter left in place for 45 mins
79
What are the 3 types of enema
Phosphate Soapy water Acetyl cysteine
80
Where does the bladder most commonly rupture
Dorsal wall
81
Diagnosis of uroabdomen
Ultrasound - free fluid in abdomen Abdominocentesis Increased serum creatinine Hyperkalemia Metabolic acidosis Hyponatremia and hypochloremia
82
Treatment for uroabdomen
Refer for surgical repair
83
Clinical signs of uroabdomen
Depression weakness Hypovolemia Stranguria/anuria Bradycardia
84
Diagnosis of umbilical infection
Thickening/abcessation of umbilicus Inflammatory markers increased
85
Treatment of umbilical infection
Broad spectrum antimicrobials Surgery if poor response to medical
86
Risk factors for respiratory disease in the foal
Systemic sepsis Congenital abnormalities Meconium aspiration Milk aspiration Birth trauma
87
Causes of acute respiratory distress immediately following bitth
Extrapulmonary disorders causes obstruction - bilateral choamal atresia Stenosis of the nares Severe laryngeal odema/collapse DDSP Sub epiglottic cysts Severe pulmonary abnormalities Congenital cardiac abnormalities
88
What is treatment for acute respiratory distress syndrome
Intranasal oxygen Ventilation Anti-inflammatories (corticosteroids) Broad spectrum antimicrobials
89
What causes atelectasis
Failure of surfactant production
90
What can meconium aspiration lead to
Mechanical airway obstruction Regional air trapping Surfactant inactivation and displacement Chemical pneumonitis and alveolitis Persistent pulmonary hypertension
91
Treatment for meconium aspiration syndrome
Aspiration of material from nasal passages and pharynx Nasal intubation with careful suction Intranasal oxygenation Anti inflammatories Pentoxyfyllone (benefits against SIRS) Treatment of secondary pneumonia
92
What can cause milk aspiration
Generalized weakness Poor suckle Dysphagia Congenital abnormalities Bottle feeding
93
How do you treat milk aspiration
Correct the cause Nasoeosophageal feeding tube Broad spectrum antimicrobials
94
How can you diagnose broken ribs in foals
Physical exam - crepitus and auscultation Ultrasonography Radiography
95
Clinical signs of EHV in foals
Typically fatal - similar to neonatal sepsis Cardiovascular and respiratory insufficiency Congested MM Leukopenia, neutropenia and lymphopenia
96
Treatment of EHV in foals
Anti-virals Supportive therapy
97
Parasitic pneumonia cause and treatment in foals
Parascaris Fenbendazole or Pyrantel
98
When is bacterial pneumonia most common in foals
1-6 months
99
Most common cause of bacterial pneumonia in foals
E.coli
100
What do all isolates of rhodococcus capable of causes disease in foals have
Plasmid encoding Virulence associated protein (VapA)
101
Rhodococcus clinical disease
Insidious Lower URT infection. Fever Lethargy Coughing Tachypnea Dyspnoea Extrapulmonary disorders
102
Treatment of rhodococcus infectiob
Oxygen Nsaids Keep cool Antimicrobials - macrolide and rifampin (Azithromycin and clarithromycin) Prevent with hyperimmune plasma
103
What is congenital hyperextension
Flaccidity of flexor muscles after birth Often resolve after a few weeks Can need protective bandaging/corrective shoeing
104
What can occur with congenital hyperflexion
May cause dystocia May prevent standing
105
How does oxytetracycline work for tendon contracture
Large dose within a few days of both Prevents the traction of collagen fibrils making them more susceptible to elongation during weight bearing
106
When does the distal radius growth plate close
24 months
107
When does the distal metacarpal growth plate close
6-9 months
108
When does the proximal phalanx growth plate close
6-12 months
109
When does the distal tibial growth plate close
17-24 months
110
When does the distal metatarsal growth plate close
9-12 months
111
What is physitis
Inflammation of the physis/ growth complex
112
Clinical signs of physitis
Heat Pain Lameness Swelling Often around carpus/fetlock
113
What can trigger physitis
Sudden feed/feed energy increase Abrupt increase in exercise Direct trauma to physis Yearling - at distal radius
114
Diagnosis/treatment of physitis
Diagnosis - radiographs and physical exam Treatment - restrict exercise, pain relief, cause correction, potential sepsis
115
Salter Harris fractures
Occur at distal physis of MC/MTIII Treated with cast coaptation <6 weeks or surgery feasible (not first line if extensive fund not available)
116
Classification of salter Harris fractures
S - straight across growth plate - type one A - type 2 - above growth plate L - type 3 - lower than growth plate T - type 4 - through growth plate
117
Where is incomplete ossification likely to occur
Cuboidal bones of carpi and tarsi
118
When does ossification of cuboidal bones occur
Last 2-3 months of gestation
119
What foals are at risk for incomplete ossification
Premature and dysmature
120
What should you do if you suspect a foal is premature/dysmature
X-ray cuboidal bones
121
Definition of angular limb deformity
Deviation from the long axis of the limb in the frontal plane
122
Treatment for incomplete ossification of cuboidal bones
Box rest
123
What are the 2 types of angular limb deformity
Varus and valgus
124
What level of carpal valgus is tolerated
2-5°
125
Aetiologies of angular limb deformity
Incomplete ossification - dysmature, premature , Placentitis in gestation, mare colic/heavy parasite burden in gestation Peri-articular laxity Acquired or congenital
126
Evaluation of angular limb deformity
Radiography - compare limbs with orthogonal views, essential for premature or dysmature Measure origin of deviation
127
Angular limb deformity conservative treatment
Box rest and controlled exercise (must have normal ossification Box rest only with incomplete ossification Trimming/rasping of foot - valgus trim lateral wall - varus trim medial wall Hoof extensions - valgus medial extension - varus lateral extension
128
When should you leave angular limb deformity
When there is peri-articular laxity
129
What radiograph should you initially take of a foal with angular limb deformity
DP and lateral
130
Where should you colimate on angular limb deformity radiographs
Mid tibia-mid Tarsus for measurements
131
When is conservative treatment okay
When entire limb is facing one way
132
Surgical treatment of angular limb deformity
One joint in a different direction
133
When should you treat surgically for angular limb deformity
In the rapid growth period
134
What do you need to be careful of with screws of angular limb deformity
Monitor and remove appropriately Correction will continue for a while after the screw is removed